Functional chest pain also called noncardiac chest pain (NCCP) are terms used to describe discomfort or pain centered in the chest that is not cardiac in origin and not of burning quality (which would more likely be heartburn).  The Rome criteria require for diagnosis the following: 1. Retroseternal chest pain or discomfort, 2.  Absence of esophageal symptoms such as heartburn or swallowing difficulties, 3. Absence of evidence for esophageal reflux or eosinophilic esophagitis, and 4. No evidence of a motility disorders.  For older individuals these criteria are not sufficient because a cardiac cause (cardiac ischmia) must be ruled out.   True cardiac chest pain is less common in younger people and is often described as tightness, squeezing, or pressing that occurs behind or to the left of the middle of the sternum with radiating pain to the shoulder or jaw.  It is usually worsened by activity or added stress.  For the most part patients with functional chest pain and a negative diagnostic workup usually have their symptoms related to increased visceral sensitivity within the esophagus.

Atypical Chest Pain